Jeremy Blachman's Weblog: 2012: Grandma update, again

It helps me to write about this stuff, even if it's probably not terribly interesting to most people reading. But I feel like it helps me to process what's going on if I write, so I will. Long day, and I guess the really good news now at the end of it is that her situation seems a lot more hopeful than it did yesterday, although she's not out of the woods just yet. On the way to the hospital this morning, we got a call saying she needed emergency surgery, that they found another blood clot in her arm, it was cutting off her circulation, no pulse in that arm, cold to the touch, and they had to get it out right away and besides that were fearing this might not be the only clot still around and posing risk for another stroke. So I expected something pretty terrible when we got to the hospital, but it was really like night and day compared to yesterday -- she was completely alert, talking, able to carry on a conversation, and really only getting caught on a word here and there that she couldn't find. She said her arm was bothering her, and she was still feeling pretty down about life and saying she didn't want to be a burden and make us worry and this whole thing was like a sign it was time to go... but as the day continued -- somewhat surprisingly to the nurses and doctors, it seemed -- her arm suddenly felt much better, color returned, pulse returned. And her spirits seemed to come back with it. She started talking about needing her denture cleaner, wanting us to bring her hairbrush tomorrow, laughing a little bit, back to her old self. It was really a pretty remarkable change from yesterday. But the potential for more clots -- and not being quite sure what was going on with the clot in her arm -- was still really worrisome. The speech therapist came in to evaluate her, and it was really interesting actually -- my grandma was really very aware of what was going on in her head and able to verbalize it -- that she knew what words she wanted to say, but just wasn't able to find them in her head and say them. And she said she's noticed a real improvement from yesterday to today, and it's been a really strange feeling. She has complete memory of the stroke happening. She said she remembers having a perfectly normal day on Tuesday, she went to the senior center, bought groceries on the way home, carried the packages into her house and then went upstairs to change her clothes. And then the phone rang, and that's when this happened -- she answered the phone and it was a friend of hers, but the friend sounded very different, and she could hear that it was the friend's voice but she couldn't understand the words she was saying. And she knew they were words, but it was all very strange, she couldn't process them. And apparently then she had the presence of mind to call my mother and tell her she felt funny, which was what got them over to her house and then to the hospital. But she said she couldn't believe something like this could happen so quickly, in an instant, and she snapped her fingers. That all of a sudden things would go from perfectly normal to something like this. But she said she could definitely tell that it was much easier to find her words today than yesterday -- and, really, the progress seemed pretty remarkable, real conversations today that I don't think a stranger could have really picked up on something being wrong. We asked her where her checkbook is, to pay bills, and she said it's in one of two places, either the office, or the -- and she paused for a moment -- the place she eats food. Kitchen, I asked. No, no, with the table. Dining room? Yes, yes, that's it. It's in one of those two places. So she was very much with it and the progress seemed really remarkable. And then the vascular surgeon came in to evaluate her arm and we had a 180-degree shift back to being really concerned -- he couldn't find a pulse in her upper shoulder on the side where the arm had been having trouble, so he was concerned that the clot wasn't really in her arm but where the arm and the carotid artery both branch off from, dangerously close to her heart, and putting her at great risk for something terrible happening. And even if we ignored the risk of anesthesia and major surgery for someone of her age and condition, he wasn't sure it was even a surgery he'd be able to do -- to get the clot out without causing problems. He wanted to do an angiogram to see exactly where the clot was, and then hopefully, if it was just in the arm, get it out with a catheter. And if it was near the heart, then he would pull out and we could evaluate options -- probably transferring her to a different hospital and unfortunately having her undergo some pretty major and risky surgery. He said the angiogram would take about an hour or an hour and a half, and they'd do it under local anesthesia and a sedative, so she wouldn't be completely put under. So we agreed to that, and then spent about two and a half hours (which felt like two and a half days) waiting, and worrying, and expecting the worst -- either that something bad was happening during the procedure, or that he'd find the clot was near the heart and she'd be in pretty dire shape, and at great risk for another stroke, this time even more devastating. But then, finally, the surgeon came out, said he imaged the whole area, the carotid artery was clear, the heart was fine, and the clot was in fact in her arm, and he had been able to get it out, and she was in the recovery room, all was good. So, best case scenario it seems. She was out of it from the sedative -- wasn't sure if she was awake or dreaming, last we spoke to her in the recovery room. But she was talking clearly and didn't seem to have given back any of the gains she's had so far. So the hope is that there won't be any more clots -- although that's the big risk at this point, and something we're really scared about -- and that she'll continue to progress -- and if the progress continues at the rate it has in just these two days, she really might get back to a point where she's functioning pretty well, and hasn't lost too much quality of life. She's a resilient one. The change just from yesterday to today was really amazing, the emotions were so up and down today, from amazed at her progress to scared out of my mind about the clot, to relieved and cautiously hopeful now at the end of the day.

Long post. Phew.

5 Comments

Sounds like she's getting excellent care. It's good that you're all around her - it's good for her, and it's good that the hospital personnel see that she has an engaged family.

Posted by: RES | May 15, 2008 at 10:56 PM

Jeremy, I honestly hope she has the best of recoveries. I can tell how close you both are to each other, and what a great woman she must be. My prayers are with her and your family

Posted by: Cecilia | May 16, 2008 at 12:46 AM